Favipiravir in Kidney Transplant Recipients With COVID-19: A Romanian Case Series

Favipiravir (FPV) is an orally administrable antiviral drug that selectively inhibits RNA-dependent RNA polymerase and has been repurposed for COVID-19 treatment. There is limited information on the use of FPV in kidney transplant recipients (KTx), who often have multiple comorbidities and run a hig...

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Bibliographic Details
Published in:Transplantation proceedings 2022-07, Vol.54 (6), p.1489-1493
Main Authors: Cismaru, Cristina, Elec, Alina Daciana, Muntean, Adriana, Moisoiu, Tudor, Lupșe, Mihaela, Antal, Oana, Elec, Florin Ioan
Format: Article
Language:English
Subjects:
Adult
Amides
Antiviral Agents - adverse effects
COVID-19 Drug Treatment
Creatinine
Female
Humans
Kidney Transplantation - adverse effects
Middle Aged
Oxygen
Pyrazines
Retrospective Studies
RNA-Dependent RNA Polymerase
Romania
SARS-CoV-2
Transaminases
Transplant Recipients
Treatment Outcome
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Summary:Favipiravir (FPV) is an orally administrable antiviral drug that selectively inhibits RNA-dependent RNA polymerase and has been repurposed for COVID-19 treatment. There is limited information on the use of FPV in kidney transplant recipients (KTx), who often have multiple comorbidities and run a higher risk for death from COVID-19. We retrospectively reviewed all KTx at our institution who got sick with COVID-19 between March 1, 2020, and May 31, 2021, and who received FPV (loading dose of 1800 mg × 2 on day 1, maintenance dose 2  ×  800 mg/d for 5-14 days) as part of their COVID treatment. We analyzed demographics, clinical course, laboratory data, management, and outcome. Nine KTx with COVID-19 received FPV; all were hospitalized. The median age was 52 years (range, 32-60 years), and women were predominant (77.7%). Eight KTx had pulmonary involvement on chest radiograph. On admission 1 patient had mild, 5 had moderate, 2 had severe, and 1 had critical disease. Leukopenia and increased creatinine were universally noted. Three patients had disease progression under treatment. Seven patients (77.7%) required additional oxygen, and 4 (57.1%) needed intensive care unit admission. Three KTx died, resulting in an overall mortality of 33.3%. Survivors did not show increased transaminases or creatinine during or after FPV treatment; leukocytes, neutrophils, and platelets improved on discharge compared with admission values. FPV appears well tolerated by KTx with COVID-19, but its clinical benefit remains unclear. Larger analyses are needed.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2021.12.011